The Relationship Between Cognitive and Behavioral Measures of Executive Function in the Context of Elementary School

Cognitive and behavioral measures are used to assess executive functions. Previous research shows that these measures tap different underlying aspects. However, much less is known about this relationship, when assessed in the context of elementary education. The current study aims to contribute to this body of research by examining the relationship between cognitive and behavioral measures (rated by parents and teachers) of executive functioning in an elementary school context, using two study designs. In study 1, the relationship between behavioral measures (using the Behaviour Rating Inventory of Executive Function: BRIEF) and cognitive measures was examined in terms of inhibitory control, planning and organization abilities as well as processing speed using a sample of 51 children (8-10 years old). In study 2, the relationship between behavioral measures and cognitive measures of inhibitory control, cognitive flexibility, and working memory was studied in a sample of 27 children (8-10 years old). Spearman’s rho coefficients were calculated between the BRIEF and neuropsychological tasks measuring the aforementioned cognitive functions. Only processing speed appeared to be positively related to parent- and teacher- rated executive function problems: lower speed of information processing was associated with more executive function problems in daily life. No other correlation between cognitive and behavioral measures of executive functioning was statistically significant. These findings in the elementary school context confirm that cognitive and behavioral measures reflect different but complementary aspects of executive functioning. Furthermore, they suggest that behavior ratings of executive functioning might reflect general problems, such as slower speed of information processing. (AU)

Childhood adversity in a youth psychiatric population: prevalence and associated mental health problems.

Background: Childhood adversity can have lasting negative effects on physical and mental health. This study contributes to the existing literature by describing the prevalence rates and mental health outcomes related to adverse childhood experiences (ACEs) among adolescents registered for mental health care.Methods: Participants in this cross-sectional study were youths (aged 12-18 years) who were referred to outpatient psychiatric departments in the Netherlands. Demographic information was collected from the medical records. The Child Trauma Screening Questionnaire (CTSQ) was used to examine the presence of ACEs and posttraumatic stress symptoms (PTSS). To assess mental health problems, we used the Dutch translation of the Youth Self Report. Descriptive statistics and frequencies were used to calculate prevalence rates across the various ACEs domains. ANOVA and chi-square tests were used to explore the relationship between ACEs and mental health.Results: Of the 1373 participants, 69.1% reported having experienced at least one ACE and 17.1% indicated exposure to four or more ACEs in their lives. Although there was substantial overlap among all ACE categories, the most frequently reported were bullying (49.2%), emotional abuse (17.8%), physical abuse (12.2%), and sexual abuse (10.1%). Female adolescents (72.7%) reported significantly more ACEs than their male counterparts (27.0%). Furthermore, a higher number of ACEs was associated with significantly more self-reported general mental health problems, an elevated prevalence of both mood and post-traumatic stress disorders, and a greater presence of two or more co-existing psychiatric diagnoses (comorbid psychiatric classification).Conclusions: This cross-sectional study on childhood adversity and its association with mental health showed that ACEs are highly prevalent in youth registered for mental health care. This study provides support for a graded and cumulative relationship between childhood adversity and mental health problems.

This study investigated the prevalence of adverse childhood experiences and associated mental health problems among Dutch youth registered for mental health care. Almost seven out of ten patients reported having been exposed to childhood adversity, and two out of ten patients reported exposure to four or more adverse childhood experiences.The results indicated a significant association between exposure to childhood adversity and mental health problems.Analysis of the data showed a cumulative effect of adverse childhood experiences, meaning that patients who reported exposure to more childhood adversity also showed more severe internalizing and externalizing mental health problems, a significant increase in both posttraumatic stress disorder and mood disorder diagnoses, and a general increase in psychiatric comorbidities.

Working memory from pregnancy to postpartum: Do women really change?

Studies indicate that pregnancy is associated with declines in working memory (WM), potentially due to intense pregnancy hormonal fluctuations. These declines extend into the postpartum period and may even be worsened due to sleepless nights and continued hormonal changes. However, previous studies finding WM stability from pregnancy to postpartum have not used a control group to examine practice effects on WM tests. The current study used a well-matched control group, fathers, to examine a) whether mothers and fathers differ on tests of WM during pregnancy and postpartum, and b) whether mothers show a postpartum WM decline, taking into account the practice effects of fathers. Results revealed that mothers (N = 75) and fathers (N = 44) performed equally well on a WM task at both time points and improved across time at a statistically equivalent rate. Use of a Reliable Change Index and a regression-based sensitivity analysis bolstered these results, indicating that taking practice effects into account, the majority of women did not improve or decline in WM from pre- to postpartum. These findings add to the literature on pregnancy-related changes in cognition and raise new questions about potential cognitive changes in men during the same period.

Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis.

We aimed to obtain reliable reference charts for sleep duration, estimate the prevalence of sleep complaints across the lifespan and identify risk indicators of poor sleep. Studies were identified through systematic literature search in Embase, Medline and Web of Science (9 August 2019) and through personal contacts. Eligible studies had to be published between 2000 and 2017 with data on sleep assessed with questionnaires including ≥100 participants from the general population. We assembled individual participant data from 200,358 people (aged 1-100 years, 55% female) from 36 studies from the Netherlands, 471,759 people (40-69 years, 55.5% female) from the United Kingdom and 409,617 people (≥18 years, 55.8% female) from the United States. One in four people slept less than age-specific recommendations, but only 5.8% slept outside of the 'acceptable' sleep duration. Among teenagers, 51.5% reported total sleep times (TST) of less than the recommended 8-10 h and 18% report daytime sleepiness. In adults (≥18 years), poor sleep quality (13.3%) and insomnia symptoms (9.6-19.4%) were more prevalent than short sleep duration (6.5% with TST < 6 h). Insomnia symptoms were most frequent in people spending ≥9 h in bed, whereas poor sleep quality was more frequent in those spending <6 h in bed. TST was similar across countries, but insomnia symptoms were 1.5-2.9 times higher in the United States. Women (≥41 years) reported sleeping shorter times or slightly less efficiently than men, whereas with actigraphy they were estimated to sleep longer and more efficiently than man. This study provides age- and sex-specific population reference charts for sleep duration and efficiency which can help guide personalized advice on sleep length and preventive practices.

Prospective relationships between sleep problems and substance use, internalizing and externalizing problems.

While research has shown that sleep problems and substance use are reciprocally associated in adults, much less is known about this association in early adolescence. The main aim of the current longitudinal study was to explore bidirectional relationships between sleep problems, substance use, internalizing and externalizing problems in young adolescents. A prospective design was used incorporating two waves (approximately 1 year interval). A total of 555 young adolescents (290 females, M age = 13.96) participated in this study. All participants completed self-report measures in classrooms during regular school hours (questionnaires about sleep quality and sleep hygiene were used to measure sleep problems). The results indicated that sleep problems predicted changes in substance use, internalizing and externalizing problems over time, but problem behaviours did not predict changes in sleep problems, adjusted for gender, age and puberty. One exception was that alcohol use negatively predicted changes in sleep problems. This study suggests that sleep problems are important precursors of substance use, internalizing and externalizing problems in adolescence.

Impulsive and reflective processes related to alcohol use in young adolescents.

BACKGROUND: Dual process models suggest that the development of addictive behaviors is the result of interplay between impulsive and reflective processes, modulated by boundary conditions such as individual or situational factors. Empirical support for this model has been repeatedly demonstrated in adult samples [for a meta-analysis, see Ref. (1)]. The purpose of this study was to test these processes as they relate to emerging alcohol use in adolescents. Specifically, the interactive effects of several measures of impulsive and reflective processes and working memory capacity (WMC) are examined as predictors of changes in alcohol use among adolescents. It was expected that measures of reflective processes would better predict changes in alcohol use than measures of impulsive processes. Moreover, it was anticipated that WMC would moderate the relation between alcohol-specific impulsive and reflective processes and changes in adolescent alcohol use. METHODS: The sample consisted of 427 adolescents (47.7% male) between 12 and 16 years of age (M = 13.96, SD = 0.78) who reported drinking alcohol at least once. Four measures of impulsive processes were included. Attentional bias for alcohol was assessed with a Visual Probe Test; approach bias toward alcohol was assessed with a Stimulus Response Compatibility (SRC) Test; and memory associations with alcohol were assessed with an Implicit Association Test (IAT) and a Word Association Test. Two measures of reflective measures were included: positive and negative expectancies. WMC was measured using a Self-Ordered Pointing Task. RESULTS: RESULTS showed that positive expectancies predicted changes in alcohol use, but this effect was qualified by an interaction with IAT scores. Moreover, SRC scores predicted changes in alcohol use only when negative expectancies were low. Attentional bias and word association scores did not predict changes in alcohol use. The relations between alcohol-specific processes or reflective processes and alcohol use were not moderated by WMC. CONCLUSION: Although there is empirical evidence for the validity of the model in predicting heavier alcohol use in adolescents, or alcohol abuse and dependence in adults, these observations do not generalize to a sample of normative, early adolescents. More specifically, results indicated that reflective processes are more important predictors of changes in alcohol use than impulsive process during adolescence.

The mediating role of alcohol-related memory associations on the relation between perceived parental drinking and the onset of adolescents' alcohol use.

AIMS: The aim of the current study was to examine the mediating role of alcohol-related memory associations in the relation between perceived parental drinking and the onset of adolescents' alcohol use. Gender and grade were also included in the analyses. DESIGN: We tested a mediation model within a structural path modelling framework using longitudinal data (two waves). SETTING AND PARTICIPANTS: The sample consisted of 608 Canadian adolescents (42.9% boys), who did not have any alcohol experiences at the first measurement. The adolescents were recruited from all grades 7-9 classes in a large school district in western Canada. MEASUREMENTS: Alcohol-related memory associations were tested with the Word Association Test. We used adolescent self-reports of alcohol use and parental drinking. FINDINGS: Results clearly showed a mediation effect of alcohol-related memory associations [estimate = 0.023, 95% confidence interval (CI): 0.002-0.044). That is, parental drinking as perceived by the adolescent was related positively to alcohol-related memory associations, which in turn predicted adolescents' alcohol use a year later. Gender and grade were related to alcohol-related memory associations. That is, boys and adolescents of higher grades had more memory associations. CONCLUSIONS: Children appear to form memory associations related to alcohol before they ever drink alcohol themselves, and these associations appear to mediate the link between their perceptions of their parents' drinking and their own initial alcohol use.

Influence of smoking cues in movies on children's beliefs about smoking.

OBJECTIVE: Experimental research has revealed that short exposure to movie smoking affects beliefs about smoking in adolescents. In this study, we tested that association in children. METHODS: In 2 experiments, participants were exposed to either a cartoon or family-oriented movie and randomly assigned to 20-minute segments with or without smoking characters. Data collection took place at elementary schools. A total of 101 children (8-10 years; 47.5% boys) were exposed to a cartoon, and in a second experiment, 105 children (8-11 years; 56.2% boys) were exposed to a family-oriented movie. Beliefs about smoking (assessed by questionnaire) and implicit associations toward smoking (single target implicit association task) were assessed after watching the movie. RESULTS: The majority of both samples of children viewed smoking unfavorably. Exposure to movie smoking had no effect on implicit associations toward smoking when experiments were analyzed separately or if the results were combined. For smoking beliefs, effects were again small and only statistically significant for social norms regarding smoking. CONCLUSIONS: Short-term exposure to smoking in cartoon and family-oriented movies had little immediate impact on beliefs about smoking in preadolescent children, but a significant cumulative impact on norms cannot be ruled out.

The moderating effect of alcohol-specific parental rule-setting on the relation between the dopamine D2 receptor gene (DRD2), the µ-opioid receptor gene (OPRM1) and alcohol use in young adolescents.

AIMS: The main aim of the study was to test the moderating effect of two genetic polymorphisms, one in the dopamine D2 receptor gene (DRD2) and one in the mu-opioid receptor gene (OPRM1), on the link between parental rule-setting and adolescent alcohol use. METHODS: A total of 214 adolescents (M(age )=13.7, 44.9% male) provided saliva samples and completed survey items describing alcohol use and parental rule-setting. RESULTS: Findings indicated that alcohol-specific parental rule-setting was more robustly associated with alcohol use for adolescents with the DRD2 A1 risk allele and for those with the OPRM1 G-allele. CONCLUSION: This study replicates the interaction between parental rule-setting and the DRD2 risk allele on adolescent alcohol use and extends the literature by demonstrating the moderating effects of the OPRM1 risk allele on the link between parental rule-setting and adolescent alcohol use.

The moderating role of working memory capacity and alcohol-specific rule-setting on the relation between approach tendencies and alcohol use in young adolescents.

BACKGROUND: Dual process models of alcohol addiction propose that the transition from normative alcohol consumption to heavy drinking is the result of an imbalance in interplay between relatively impulsive or automatic and reflective or controlled processes. The current study examines whether impulsive and reflective processes are also detectable in a sample of adolescents with limited alcohol use. METHODS: Specifically, we tested the interaction between alcohol approach tendencies and 2 types of reflective processes, working memory capacity (WMC) and alcohol-specific rule-setting, on changes in alcohol use of 238 young adolescents (mean age: 13.82 years). Gender differences in these associations were also explored. RESULTS: Results showed that WMC did not moderate the relation between approach tendencies and subsequent alcohol use, whereas rule-setting did, with stronger associations between approach tendencies and alcohol use for male adolescents reporting more permissive parents than male adolescents with parents enforcing stricter rules involving alcohol use. Associations between approach tendencies and subsequent alcohol use did not emerge for female adolescents. CONCLUSIONS: Results indicate that even in a sample of adolescents with limited drinking experience, automatic processes are positively associated with alcohol use for male adolescents that are not motivated by parents to control their drinking.

The effect of the OPRM1 and DRD4 polymorphisms on the relation between attentional bias and alcohol use in adolescence and young adulthood.

BACKGROUND: The incentive sensitization theory posits that in the transition from sporadic to problematic alcohol use, the incentive value of alcohol increases (wanting) while its hedonic effects (liking) do not change or decreases. The effect of the OPRM1 c.118A>G polymorphism, associated with liking and wanting, and the DRD4-VNTR polymorphism, related to wanting, on the relation between attentional bias and alcohol use was investigated. METHODS: A total of 195 young adolescents (Study 1) and 86 young adult male heavy drinkers (Study 2) completed a visual probe test. Saliva samples were collected to test both polymorphisms. RESULTS: In Study 1, attentional bias was positively associated with adolescent alcohol use only for OPRM1 G-allele carriers. In Study 2, attentional bias was positively associated with problem drinking for carriers of a DRD4 long allele. DISCUSSION: It is tentatively proposed that an attentional bias for alcohol is related most strongly to liking and wanting in early adolescents, while in young adults, an attentional bias may reflect wanting. In addition, individual differences associated with two both genetic markers should be taken into account when examining the relation between attentional bias and alcohol use.

Puberty-dependent sleep regulation and alcohol use in early adolescents.

BACKGROUND: Research has shown a bi-directional relation between alcohol use and sleep regulation in adults. Much less is known about this association in early adolescents, while profound puberty-dependent transitions regarding sleep patterns take place in early adolescence. Moreover, puberty has been associated with an increase in alcohol use of adolescents. METHODS: In this study, we investigated the associations between pubertal development, sleep preference, sleep problems, and alcohol use in 431 early adolescents (mean age: 13.66). Second, it was studied whether the associations changed when controlling for adolescent internalizing and externalizing problems. Furthermore, we included gender as a moderator on all the associations. RESULTS: Results showed that pubertal development was positively associated with sleep problems and more evening-type tendencies (e.g., favoring later bedtimes), which in turn were positively related to alcohol use. Underlying psychopathology, gender and educational level did not change these relationships. CONCLUSIONS: From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.

Implicit and explicit cognitions related to alcohol use in children.

Research has indicated that implicit and explicit alcohol-related cognitions jointly predict alcohol use in adolescents and adults. Only few studies assessed these cognitions in children. Associations between alcohol cognitions and alcohol use were tested in two studies with 10 year olds (Study 1; N=99) and 11-12 year olds (Study 2; N=35). Furthermore, the role of parental alcohol use was examined. Implicit alcohol cognitions were assessed in an Implicit Association Test (IAT) using pictures of alcohol and soft drinks as target stimuli and happy versus angry faces as attribute stimuli (children's faces in Study 1, adults' faces in Study 2). Explicit expectancies and parental alcohol use were assessed with questionnaires. Children demonstrated a relatively stronger association between alcohol and negative facial expressions, and in Study 2, this association was negatively related to alcohol use. In Study 2, paternal drinking was related to implicit negative associations and explicit arousal associations. These studies show that young children have both implicit and explicit alcohol-related cognitions and both appear to play a role in explaining emerging alcohol use of elementary schoolchildren.

Testosterone increases amygdala reactivity in middle-aged women to a young adulthood level.

Testosterone modulates mood and sexual function in women. However, androgen levels decline with age, which may relate to the age-associated change in sexual functioning and the prevalence of mood and anxiety disorders. These effects of testosterone are potentially mediated by the amygdala. In the present study, we investigated whether the age-related decline in androgen levels is associated with reduced amygdala activity, and whether exogenous testosterone can restore amygdala activity. Healthy young and middle-aged women participated during the early follicular phase of the menstrual cycle, and amygdala responses to biologically salient stimuli were measured with functional magnetic resonance imaging (fMRI). Androgen levels were lower in middle-aged than young women, which was associated with decreased amygdala reactivity. Endogenous testosterone levels correlated positively with amygdala reactivity across the young and middle-aged women. The middle-aged women received a single nasal dose of testosterone in a double-blind, placebo-controlled, crossover manner, which rapidly increased amygdala reactivity to a level comparable to the young women. The enhanced testosterone levels correlated positively with superior frontal cortex responses and negatively with orbitofrontal cortex responses across individuals, which may reflect testosterone-induced changes in amygdala regulation. These results show that testosterone modulates amygdala reactivity in women, and suggest that the age-related decline in androgen levels contribute to the decrease in amygdala reactivity.